Chronic Kidney Disease Explained: Causes, Symptoms, And Treatments
Just like the heart, which works nonstop to pump blood and keep you alive, your kidneys are constantly working and play a vital role in your body. Every minute, your kidneys — which are the size of a computer mouse — filter all of the blood in your body, says the Centers for Disease Control and Prevention (CDC). Filtering means taking out things like toxins, waste, and extra fluid. Controlling fluid levels, in turn, helps keep your blood pressure stable.
Unfortunately, the CDC estimates that 1 in 7 American adults has chronic kidney disease. When someone has chronic kidney disease, their kidneys don't filter as well as they should. Over time, this causes a buildup of toxins in the body, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Chronic kidney disease is labeled as "chronic" because it takes a while to develop. It can lead to a variety of health conditions, and is a serious matter. Here's what you need to know about its causes, symptoms, and treatment.
Who is at risk for chronic kidney disease?
A wide variety of people can be affected by chronic kidney disease, but there are some risk factors to be aware of.
There are some health problems that put you at higher risk, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes is the first they list because it's the leading cause of chronic kidney disease. Diabetics have a hard time regulating their blood sugar levels, and high blood sugar can damage the blood vessels in your kidneys. Roughly 1 in 3 people with diabetes also has chronic kidney disease.
High blood pressure is another cause, and it similar to diabetes because it causes damage to the blood vessels in the kidney. Roughly 1 in 5 adults with high blood pressure also has chronic kidney disease. People with a family history of the illness — meaning those who have an immediate family member that has chronic kidney disease — are at a higher risk of developing it. Heart disease also seems to be related, although researchers are still working to find a definite link.
Causes of chronic kidney disease
Damage to your kidneys can cause kidney disease, as this can prevent them from filtering blood. Diabetes and high blood pressure both damage the kidneys, but there are many other problems that can cause chronic kidney disease.
The Cleveland Clinic lists conditions that damage the kidneys, such as glomerulonephritis. There are filters in your kidneys called glomeruli. If these are damaged, it's harder for your kidney to do its job properly. Polycystic kidney disease, a genetic condition, causes cysts filled with fluid to form in your kidneys, making it function improperly.
If you have kidney stones or an enlarged prostate, which can obstruct the urinary tract, you're more likely to develop chronic kidney disease. Immune diseases such as lupus also make you more likely to develop kidney disease. An example of an immune issue is membranous nephropathy, where the body attacks the parts of your kidney that filter waste. Repeated kidney infection is another cause.
Other issues that affect the kidney
There are many potential causes for chronic kidney disease, and many of them are out of your control. Kidney disease affects 37 million Americans, perhaps because there are many causes (per the National Kidney Foundation). Unfortunately, aging increases your risk. Certain races such as African Americans and American Indians, which are more likely to experience high blood pressure, are also more likely to develop chronic kidney disease.
There are some problems that lead to kidney disease that occur in the womb. These problems can cause damage or make you more likely to experience damage to your kidneys. One such malformation is the occurrence of a narrowing, which blocks the normal flow of urine. In fact, it can cause urine to flow back up into the kidney. If this happens, it can cause an infection in the kidneys and damages them over time.
Even though there are so many potential causes, roughly two-thirds of all chronic kidney disease comes from diabetes and high blood pressure, explains the National Kidney Foundation.
Common symptoms of kidney disease
The serious symptoms of kidney disease take a long time to develop, according to the National Kidney Foundation. For that reason, you might not develop symptoms until the problem is advanced. However, there are some more mild symptoms that can be indicative of a problem. For example, you might feel tired and have trouble concentrating. Trouble sleeping and puffiness around the eyes in the morning are common symptoms, as is muscle cramping at night. You also might need to urinate frequently throughout the night.
Other signs of chronic kidney disease include poor appetite. Dry, itchy skin might occur. You might have swollen feet and ankles, which can be uncomfortable. These signs and symptoms of chronic kidney disease are relatively mild and could be cause by other factors. However, if you're concerned and feel the need to check for kidney disease, you should see a doctor.
Seemingly unrelated symptoms of kidney disease
Some of the symptoms of kidney disease might seem completely unrelated and random. However, it can help to know and watch out for these signs, because it's better to detect chronic kidney disease as early as you can.
One strange symptom, as explained by Johns Hopkins Medicine, is ammonia breath, or a metallic taste in your mouth. This happens when waste builds up in the blood (which is also known as uremia). Uremia can give you bad breath and make food taste differently. You might even lose weight, because food tastes bad to you. In addition, it can cause nausea and vomiting.
If fluid builds up in the lungs, you might experience shortness of breath, especially if fluid in the lungs occurs along with anemia.
Anemia, a common result of kidney disease, causes a lack of oxygen in the brain, which can lead to confusion and trouble concentrating. Another problem with anemia is that it can make you feel cold, even in warm environments.
Health consequences of chronic kidney disease
Chronic kidney disease leads to other health problems, which can also be serious. The CDC lists some of these health problems, two of which include heart disease and stroke. These are perhaps the most serious consequences of kidney disease, as they can be deadly. Many health complications occur because kidney disease causes excess waste and fluid to build up in the body.
Anemia, which is a drop in the number of red blood cells inside your body, is yet another potential consequence of kidney disease. This can be a major problem, since red blood cells are responsible for carrying oxygen to different parts of your body.
Additionally, you can be more likely to experience infections if you have kidney disease, meaning your immune system isn't functioning properly. The amount of calcium in your blood can drop, while its potassium and phosphorus levels rise.
Lastly, chronic kidney disease can also cause depression and an overall lower quality of life.
Other complications from kidney disease
The kidneys are undoubtedly important, and if they don't function properly, a wide variety of bodily functions can be thrown off. However, not all of the complications that arise from kidney disease are deadly, or even easy to notice.
The Cleveland Clinic explains that brittle bones are a possible complication, which can be difficult to detect unless you see a doctor or suffer an injury. Meanwhile, certain problems aren't terribly dangerous, but can seriously impact your life (such as erectile dysfunction and fertility problems).
Gout is another problem that can come about from chronic kidney disease and severely affect your day-to-day existence. While it's not deadly, gout can be painful. It's a form of arthritis, says the Cleveland Clinic, which results from too much uric acid in the body. It primarily occurs in the foot, and can be treated with lifestyle modifications and dietary changes. Kidney disease can also cause something called metabolic acidosis, which is an imbalance between the acid and base levels in your blood.
How is chronic kidney disease diagnosed?
If you've noticed some of the signs, symptoms, or complications that can arise from chronic kidney disease — or if you are in a higher-risk category — it's wise to check in with your doctor. They can test for chronic kidney disease using a few different methods.
One of the ways is via a simple blood pressure test, which your doctor might do every time you come into the office, according to the American Academy of Family Physicians. This is because high blood pressure is a risk factor for chronic kidney disease. A urine albumin test is another way your doctor can check to see if you have chronic kidney disease. This test is used to see how much protein is in your urine. Yet another method is a blood test. Specifically, your doctor will check your serum albumin. This tells them how much waste is in your blood.
Your doctor might also recommend that you don't get tested. In fact, the American Academy of Family Physicians recommends that adults without symptoms and aren't at high risk for chronic kidney disease shouldn't be screened.
Ways to keep your kidneys healthy
If you have chronic kidney disease, you can make lifestyle modifications to keep your kidneys healthier for longer. MedlinePlus describes a few steps you can take, such as lowering the amount of sodium you consume. Controlling your blood pressure is important, and a healthcare provider can help you figure out ways to do so. If you're diabetic, keeping your blood sugar within an appropriate range is also important.
Other lifestyle changes you can make are to cut down or eliminate alcohol and stop smoking. Changing your diet might help, particularly if you choose heart-healthy foods. Eating more fruits, vegetables, and whole grains is beneficial. Eating low-fat dairy products can also be a boon. If you're overweight, losing weight will likely do you good.
Additionally, try to exercise regularly, or just increase your activity level. While these changes can't treat kidney disease, they can improve your overall health and wellbeing and prevent you from developing kidney disease in the first place.
Treatment options for chronic kidney disease
The way your doctor decides to treat your chronic kidney disease depends on a variety of factors, explains the American Academy of Family Physicians.
Since kidney disease can cause other health problems, your doctor has to be mindful of those as they navigate your kidney treatment plan. One common problem is high cholesterol, which your doctor can help you tackle by using cholesterol-lowering medications. High triglyceride levels are also problematic, and your doctor can help you lower those as well.
Anemia, which is a common problem associated with chronic kidney disease, can be dangerous and should be treated by your doctor. Weak bones are another common issue that you might need to fix as you deal with chronic kidney disease. Your doctor might also send you to a nutritionist to work on your diet. One thing they might work with you on is lowering your protein intake, since too much protein can be stressful for the kidneys. They might also recommend boosting your fluid intake.
Multidisciplinary kidney care
Since the treatment of chronic kidney disease can be so multifaceted and require many specialties to deal with the complications that can come with it, the University of Michigan uses a multidisciplinary approach. They explain that research shows multidisciplinary treatments work best at delaying the progression of chronic kidney disease and improving quality of life for the patient.
One prong of this multidisciplinary approach is medication. The University of Michigan involves a pharmacist in the process, to make sure each patient is taking the correct medication. Since they might be on multiple medications to deal with complications, they need to make sure that the drugs interact properly. Meanwhile, a nutritionist can work with patients to make sure that they're following the best diet for their needs.
They also have a social staff to improve the psychological wellbeing of patients with kidney disease, including those transitioning to using dialysis or transplant. These specialists work with a nephrologist (a doctor who specializes in kidneys).
Over-the-counter supplements for kidney disease
There are some basic supplements that can help with your kidney disease. These over-the-counter supplements, which you don't need a prescription for, can improve your quality of life and help you deal with complications. However, it's important to note that you should check with your doctor before taking anything. That includes herbs and supplements, as well as other over-the-counter drugs. Since kidney disease can be so complex, your doctor should approve any changes before you make them.
One over-the-counter treatment that your doctor might recommend is iron, says Mount Sinai. You can get it in pill form, or your doctor can provide a shot. Blood transfusions can also be used to boost your iron. Taking iron can help with anemia, one of the complications from chronic kidney disease. Other supplements you can take include vitamin D and calcium. These supplements won't replace anything you should already be doing, so continue your diet and medications as recommended by your doctor.
Altered immune function from kidney disease
Changes in the immune system from kidney disease are complicated. On one hand, it can weaken your immune system. It can also cause an overreaction, according to a paper published in Advances in Kidney Disease. The effects of kidney disease on your immune system can lead to disease and infection, which causes roughly 70% of the deaths attributed to kidney disease.
When the immune system is too weak, you're more susceptible to infections, cancers associated with viruses, and a diminished response to vaccines. However, your immune response can be exaggerated, which leads to excessive inflammation.
A possible outcome of increased inflammation is atherosclerosis, which is a narrowing of the arteries caused by a buildup of plaque, according to the National Heart, Lung, and Blood Institute. The paper ends by suggesting that more research should be done that focuses on treating immune problems in people with chronic kidney disease, as this could reduce the number of fatalities.